As sales slide in wealthy nations, tobacco ads target poor countries

There are 81 percent more tobacco ads in poor countries than in wealthy ones, and the poorer the country, the more often cigarettes are found for sale in shops, says a new WHO study.

Mark Schiefelbein/AP
A man uses his smartphone as he sits in front of racks of cigarettes while waiting for customers in his convenience store in Beijing. Research published in the medical journal The Lancet says one in three of all the young men in China are likely to die from tobacco, but that the number can fall if the men quit smoking.

The decades-long campaign against cigarette smoking in wealthy countries has successfully reduced smoking rates there. But it also inspired tobacco companies to look for other opportunities to replenish lost profits: young people in poor countries.

Tobacco marketing, which is heavily regulated in the US and Europe, is pervasive in countries such as India, Pakistan, and Zimbabwe, despite a 2005 World Health Organization (WHO) anti-smoking convention that urges all governments to restrict the marketing and availability of tobacco.

A study of 16 nations published Tuesday in the Bulletin of the World Health Organization, found 81 percent more tobacco ads in these lower-income countries than in high-income ones such as Canada, Sweden, and the United Arab Emirates. As the 20th-century battles against tobacco marketing in the US have shown, these ads – even if implicitly – often target children.

"The tobacco industry uses marketing to drive the uptake of smoking among children and young people," said University of Bath public health professor Anna Gilmore in a study announcement.

"Its sales are falling in high-income countries and so its future profitability depends on getting young people hooked on smoking in low-income countries,” she said.

But tobacco companies say that they're simply taking their business into markets where there's demand, and they're following local regulations there.

Imperial Tobacco, based in Bristol, UK, said in a statement to CNN a few years ago, "The risks associated with smoking are well known worldwide and enable people to choose whether or not to smoke."

Phillip Morris, the world's largest tobacco company, pointed out to the news network that tobacco products "are generally subject to extensive regulation" internationally, emphasizing that it "is firmly opposed to smoking by minors."

Dr. Gilmore, who is the director of the Tobacco Control Research Group at the British university, says low- and middle-income countries need to work harder to ban tobacco advertising and sponsorships. She calls the spread of smoking in developing countries an “epidemic,” referencing a 1994 study that followed smokers over 40 years and found that half died from smoking-related diseases.

Millions more could die from smoking by 2020, according to the report authors, who studied 462 communities between 2009 and 2012. Most of the smoking-related deaths in the next several years, 70 percent, will be in developing countries, the authors estimate.

It is depressing that 10 years after the framework convention came into force, tobacco marketing remains ubiquitous,” Gilmore wrote today in The Guardian. She urged, “A concerted effort is needed to implement and enforce marketing restrictions before millions more die needlessly.”

The WHO’s convention on tobacco control was introduced in 2005 to curb tobacco use in developing countries, which was growing rapidly even as it was declining in wealthier ones. Though nearly 200 countries have expressed commitment to this convention, only 14 have ratified it.

Even in countries that signed the treaty, says the study, tobacco marketing was ubiquitous during the three years of the study.

Part of the reason there’s been little action, says Gilmore, is the same reason the US is still fighting tobacco companies’ efforts to market to children, now in the form of e-cigarettes: These companies are powerful lobbyists.

“In some [low- and middle-income countries] the tobacco industry is prepared to go to any lengths (including bribing illegally) to prevent policies that run counter to its interests,” Gilmore wrote in an e-mail to The Christian Science Monitor.

A recent investigation by the BBC found that representatives from three African countries took bribes from British American Tobacco to undermine the anti-smoking efforts associated with the WHO convention.

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